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Thromb Haemost 2025; 125(10): 1038-1047
DOI: 10.1055/a-2495-1350
Stroke, Systemic or Venous Thromboembolism

C-reactive Protein, Genetic Susceptibility, and the Long-Term Risk of Venous Thromboembolism in Patients with Past Cancer

Yunlong Guan
1   Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
,
Zeyu Gan
1   Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
,
Si Li 
1   Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
,
Xi Cao
1   Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
,
Ao Zeng
1   Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
,
Jing Li
2   Department of Oncology, Xiang yang Central Hospital, Hubei University of Arts and Science, Xiang yang, Hubei, China
,
Wei Gong
2   Department of Oncology, Xiang yang Central Hospital, Hubei University of Arts and Science, Xiang yang, Hubei, China
,
Jun Deng
3   Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
,
Xingjie Hao
1   Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
› Author Affiliations
Funding This work is supported by National Natural Science Foundation of China (No. 32470658), Fundamental Research Funds for School of Public Health, Tongji Medical College, Huazhong University of Science and Technology (2022gwzz01), and Knowledge Innovation Special Project of Wuhan.
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Abstract

Background

Several studies have indicated that C-reactive protein (CRP) level is associated with the risk of venous thromboembolism (VTE) in the general population. However, CRP appears to be unrelated to VTE events in patients newly diagnosed with cancer. As the survival time of cancer patients increases, the effect of CRP on the long-term risk of VTE may change. We aimed to investigate the association between CRP and VTE in cancer survivors and further assess the modification effect of genetic susceptibility.

Methods

The Cox proportional hazards model was used to evaluate the association between CRP levels and VTE risk as well as to investigate the joint effect of CRP and genetic susceptibility. The Kaplan-Meier curve and restricted cubic spline were used to visualize the relationship between CRP and VTE.

Results

This study included 27,806 participants with cancer diagnosis at baseline in the UK Biobank. Over a follow-up period of 344,636 person-years, a total of 1,151 VTE events were recorded. Participants were divided into four groups based on CRP level quartiles. The adjusted hazard ratios (95% CIs) of Q1, Q2, Q3, and Q4 were 1.00, 1.20 (0.99–1.44), 1.25 (1.04–1.50), and 1.51 (1.25–1.82), respectively. For those with high genetic risk of VTE, high CRP had an additional increased risk for VTE.

Conclusion

CRP can be used as a predictive biomarker for VTE risk in cancer survivors, especially in those with high genetic risk. Future research can explore whether prevention and treatment strategies for VTE can be developed based on CRP for cancer survivors.

Keywords

venous thromboembolism - C-reactive protein - cancer - polygenic risk score - cohort study

Ethical Approval Statement

The UK Biobank study protocols were granted by the North West Multicenter Research Ethics Committee. The application number of the UK Biobank in our study was 88159.


Data Availability Statement

All information is available from the UK Biobank (https://www.ukbiobank.ac.uk/). Data are available on application.


Authors' Contribution

Y.L.G., J.D., and X.J.H. conceived the idea for the study, planned and carried out all the statistical analyses, and drafted the manuscript. Z.Y.G., S.L., X.C., A.Z., and J.L. advised on all statistical aspects and interpreted the data. X.J.H. and W.G. provided a critical review of the manuscript. All the authors have read the manuscript and approved the final version of the manuscript.


Supplementary Material



Publication History

Received: 22 July 2024

Accepted: 02 December 2024

Accepted Manuscript online:
03 December 2024

Article published online:
27 December 2024

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